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Organization Active NPI

Spartan Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • New Albany, MS
National Provider Identifier
1972791978
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SPARTAN ORTHOPAEDICS, LLC
Practice address
206 Oxford Rd
New Albany, MS 38652-3115
Phone
(662) 534-2227
Fax
(662) 534-2330
NPI assigned
Oct 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer C Bullock
Title
President
Phone
(662) 534-2298

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

206 Oxford Rd
New Albany, MS 38652-3115

Mailing address

PO Box 15580
Belfast, ME 04915-4050
Phone (662) 534-2227

Other practice location 1

6515 Poplar Ave Ste 106
Memphis, TN 38119-4878
Phone (901) 426-1090

Other practice location 2

6518 Goodman Rd Ste 104
Olive Branch, MS 38654-9809
Phone (662) 420-7350

Other identifiers 2

IdentifierTypeStateIssuer
200025185MedicaidMS
002654844MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20080303000264 MS Part B Supplier - Clinic/Group Practice 4880778786 Receives reassigned benefits from 17 practitioners
Practice locations: New Albany, MS; Olive Branch, MS
O20100930097000 MS DME Supplier - Physician - Orthopedic/Orthopedic Surgery 4880778786 Practice locations: New Albany, MS
O20160803001940 TN Part B Supplier - Clinic/Group Practice 4880778786 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

806 Earl Frye Blvd
Amory, MS 38821
Phone (662) 478-2450

173A Whaley Dr
Ste B
Holly Springs, MS 38635

273B Whaley Dr
Holly Springs, MS 38635

3964 Goodman Rd E
Ste 128
Southaven, MS 38672
Phone (662) 420-7350

3964 Goodman Rd E
Ste 128129
Southaven, MS 38672
Phone (662) 655-0456

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1972791978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15580",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154050",
            "telephone_number": "662-534-2227",
            "fax_number": "662-534-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 OXFORD RD",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523115",
            "telephone_number": "662-534-2227",
            "fax_number": "662-534-2330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6515 Poplar Ave Ste 106",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381194878",
            "country_code": "US",
            "telephone_number": "901-426-1090",
            "fax_number": "901-426-1091",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6518 Goodman Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386549809",
            "country_code": "US",
            "telephone_number": "662-420-7350",
            "fax_number": "662-932-3010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPARTAN ORTHOPAEDICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-534-2298"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200025185",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002654844",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.